Other ear, nose, mouth and throat diagnoses with complications
What 14 hospitals in the U.S. charged and were paid for a Medicare hospital stay for other ear, nose, mouth and throat diagnoses with complications (DRG 155), from 2024 Medicare claims.
Average charge
$60,942
Hospital list price billed
Average payment
$10,280
Medicare + patient + other payers
Medicare paid
$7,396
Average per stay
Volume
205
Medicare hospital stays
Hospitals in the U.S. billed an average of $60,942 for other ear, nose, mouth and throat diagnoses with complications, about 5.9 times the average total payment of $10,280.
These are averages for patients with original (fee-for-service) Medicare. Private insurance pays different, negotiated prices, and what you owe depends on your plan's deductible and coinsurance. Use these figures to compare hospitals, not as a quote.
Paid $10,280Billed $60,942
About 17¢ was paid for every $1 hospitals in the U.S. billed for this stay.
Medicare prices this stay in 2 versions, by how sick the patient was. Compare them:
Other ear, nose, mouth and throat diagnoses with complications cost by state
Volume-weighted averages for each state's hospitals. Select a state to see every hospital.
| State | Hospitals | Avg charge | Avg payment | Range |
|---|---|---|---|---|
| California | 1 | $121,607 | $12,793 | – |
| Delaware | 1 | $28,340 | $8,186 | – |
| Florida | 3 | $64,213 | $8,862 | $7,449 – $9,884 |
| Illinois | 1 | $27,796 | $8,804 | – |
| Massachusetts | 2 | $22,835 | $10,378 | $7,811 – $13,160 |
| New Jersey | 2 | $107,323 | $12,751 | $12,251 – $13,251 |
| New York | 2 | $66,902 | $13,030 | $12,679 – $13,402 |
| Pennsylvania | 2 | $52,637 | $8,422 | $8,173 – $8,555 |
Hospitals that treat the most Medicare patients for this
| Hospital | Stays | Avg charge | Avg payment |
|---|---|---|---|
| Lehigh Valley HospitalAllentown, PA | 26 | $61,819 | $8,555 |
| Adventhealth OrlandoOrlando, FL | 24 | $53,282 | $9,884 |
| New York-Presbyterian HospitalNew York, NY | 18 | $66,442 | $12,679 |
| University HospitalStony Brook, NY | 17 | $67,389 | $13,402 |
| Evanston HospitalEvanston, IL | 14 | $27,796 | $8,804 |
| Abington Memorial HospitalAbington, PA | 14 | $35,585 | $8,173 |
| South Shore HospitalSouth Weymouth, MA | 13 | $14,322 | $7,811 |
| Cedars-Sinai Medical CenterLos Angeles, CA | 12 | $121,607 | $12,793 |
| Umass Memorial Medical Center INCWorcester, MA | 12 | $32,058 | $13,160 |
| Christiana Care Health Services, INC.Newark, DE | 11 | $28,340 | $8,186 |
| Sarasota Memorial HospitalSarasota, FL | 11 | $47,427 | $7,449 |
| HCA Florida Lawnwood HospitalFort Pierce, FL | 11 | $104,849 | $8,046 |
| Morristown Memorial HospitalMorristown, NJ | 11 | $85,480 | $12,251 |
| Robert Wood Johnson University HospitalNew Brunswick, NJ | 11 | $129,166 | $13,251 |
Questions
How much does other ear, nose, mouth and throat diagnoses with complications cost in the U.S.?
In 2024 Medicare data, a hospital stay for other ear, nose, mouth and throat diagnoses with complications (DRG 155) at 14 hospitals in the U.S. was billed at $60,942 on average, while the average total payment was $10,280, of which Medicare paid $7,396. Your own cost depends on your insurance, deductible and the hospital.
Which states pay the most and least for other ear, nose, mouth and throat diagnoses with complications?
Among states with at least three hospitals reporting, the average total payment was highest in Florida ($8,862) and lowest in Florida ($8,862).
Why are hospital charges so much higher than payments?
Charges are a hospital's list prices. Medicare pays fixed rates set in advance, and private insurers negotiate their own discounts, so almost nobody pays the full charge. For this stay in the U.S., average charges were 5.9 times the average payment. Uninsured patients can ask the hospital about its financial assistance (charity care) policy and cash prices.
Source: CMS, Medicare Inpatient Hospitals by Provider and Service, 2024. Average total payment includes Medicare's payment, the patient's deductible and coinsurance, and any other payer. CMS omits hospitals with fewer than 11 hospital stays for privacy. About the data.